Sometimes Angioplasty is not a solution

A 28 year male patient diagnosed as hyperacute myocardial infarction (AWMI) referred from periphery for the further management.  Primary angioplasty was planned, his angiogram showed thrombus in left coronary system( LMCA Left main coronary artey , LAD left anterior descending artey , LCX left circumflex  coronary artey and diagonal artey. Considering all these lesions, patient might required 3 or more stents and even he may succumb during the procedure (because of acute nature of disease, huge  thrombus load ). And even after successful angioplasty, such  young patient with 3 stents may need another revascularization procedure in his lifespan. So Angioplasty ( stenting ) was deferred.  Intracoronary Tirofiban was given and patient was taken out of Cathlab. He was thrombolysed with streptokinase (Rs 2500 ). For next 3 days patient received tirofiban and heparin infusion. During that period patient recovered symptomaticaly and his BP stabilized. Check angiogram showed complete resolution  of thrombus in all the  vessels and patient recovered without need of stents.

 

Thanks to Cathlab Technicians,  ICU staff and Doctor's at Bharati Hospital Sangli 

 

Note : Most of the young patient have thrombus load and could be managed by thrombolysis.